MAWS Response to the Petition Entitled “Corrective Action Needed By the Washington State Department of Health”
Dear members and friends of MAWS,
The above named petition has received a good deal of attention since it was drafted. Some of that discussion has been undertaken without a full understanding of the issues raised by the DOH complaint and this petition in response. MAWS members have correctly sought information and clarification from their professional organization.
MAWS does not support the petition at this time. What follows is the rationale for this decision, as well as actions MAWS is undertaking to support its membership regarding the questions and concerns that the petition has raised.
MAWS recognizes, and Department of Health (DOH) data confirms, that the majority of complaints filed against midwives are spurious and result in no action taken. These complaints stem from a lack of respect for and understanding of the services midwives provide, our training, and our commitment to excellent care and safety for the families we serve. We empathize with all midwives who have had such complaints and recognize the personal distress, grief, and professional and financial losses they can cause. MAWS is committed to supporting our member colleagues who find themselves engaged in legal and administrative processes. At the same time, we recognize the integral role of the DOH in safeguarding the public, and understand that complaints brought, spurious or not, warrant investigation to ensure public safety. MAWS supports what we believe to be fair legislative and administrative processes that ultimately result in a stronger collective profession and safe access to midwifery care for consumers.
We all strive for safe, professional practice that serves both the autonomy of midwifery care providers and desires of clients, and we recognize that our choice of birth attendants impacts our ability to safely provide care. Our profession has a long history of mentorship and apprenticeship, and we support the selection of other qualified health professionals, such as Licensed Midwives (LMs), as mentors to less experienced midwives and as birth assistants. In fact, this choice reflects what we believe to be one of the most responsible models for community birth safety. We further recognize the challenges that can at times face rural midwives and/or solo practice midwives in finding qualified birth assistants, and the imperative for the Midwifery Advisory Committee (MAC) along with the DOH to clarify the qualifications and roles of birth assistants. This clarification is currently in process. All LMs must recognize, when choosing birth attendants or choosing to assist at births, that we are held accountable to the level of our license, expertise, and experience -- regardless of the role we are there to play. This is a liability and a privilege afforded to all in professional practice and healthcare professions.
In regard to the petition itself, upon close reading and reflection, we find that the wording is ambiguous, the statements made do not consistently stand up to scrutiny, and we lack the clarity necessary to support and sign the petition. To be clear, it is the petition itself we find ourselves unable to support in good faith, not any of the individual midwives involved. This is not a condemnation of the midwife under investigation or of those who chose to sign, and MAWS remains steadfastly in support of the midwives involved in their pursuit of fair, transparent, and equitable administrative and legal processes. We are poised to assist said midwives in navigating the DOH complaint process or any additional legal processes that arise, a service we are committed to providing to all MAWS members.
All of that said, we recognize that the petition, and its ensuing conversation, warrant further discussion and action from MAWS to meet the needs of our members. As such, and in keeping with the MAWS mission statement “[t]o promote reproductive health and well-being through the promotion and support of the profession of midwifery,” the following are the actions MAWS is currently undertaking to continue to support our professional growth and development:
MAWS is and remains committed to providing its membership with unbiased, accurate information, education, and support. With any issue that has the potential to deepen the fractures within our midwifery community, we seek instead to create an opportunity for civic engagement and professional development. If you have any remaining questions or concerns, please don’t hesitate to contact us at email@example.com. We look forward to sharing the results of our efforts listed above as soon as possible.
Signed on February 11, 2019, unanimously, by the Midwives’ Association of Washington State Board of Directors
Neva Gerke, LM, MSM, MAWS President and Chair, MAWS Legislative & Policy Committee
Kat Potthoff, LM, CPM, MAWS Vice President
Tiffani Hoffman, LM, CPM, MAWS Secretary
Elizabeth Arcese, MA, LM, CPM, MAWS Treasurer
Amelia Bowler, MAWS Office Manager
Melanie Dickson, LM, CPM, Chair, Quality Management Program
Claire Catania, Midwifery Consumer
Felicia Dunbar, MSM, LM, CPM
Kristin Eggleston, LM, CPM
Mariah Falin, Consumer Representative
Deborah Gleisner, ND, LM, MAWS Birth Center Representative
Charlee Haller, Student Representative
Sunita Iyer, ND, LM
Cynthia Jaffe, LM
Sara Lillie-Lugo, Student Representative
Juniper Moon, MSM, LM, CPM
Susan Rainwater, MSW, Midwifery Consumer
Jennifer Segadelli, JD, MSM
Brittany Seidel, MSM, Consumer Representative
Lisa Stotts, MSM, LM, CPM
Chelsey Swan, Consumer Representative
Jessica Swan, MSM, LM, CPM
Christine Tindal, LM, CPM, MSM, Peer Review Coordinator
You never know what you’ll miss if you don’t show up for Midwives’ Lobby Day…
This year, we had a record turnout: more than 80 licensed midwives, midwifery students, and healthcare consumers braved the rain and showed up in Olympia on January 18th. Many of you have probably already seen the video that captured the highlight of the day--and, some might say, one of the most memorable moments in MAWS’ history: you can watch the video here. Thanks to a good deal of behind-the-scenes finagling by our fabulous lobbyist, Amber Ulvenes, we got to sit in the House gallery and witness the unanimous vote in support of HB 2016, which would give midwives and doulas access to WA State prisons to provide voluntary prenatal and postpartum care. Several legislators spoke from the floor and sang the praises of the midwives who’d been there for the births of their babies or grandbabies. Then, the Speaker Pro Tempore asked us to stand, and MAWS received a standing ovation from the entire WA State House of Representatives. It was epic.
Meanwhile, over in one of the Senate hearing rooms, MAWS President, Neva Gerke, was testifying on SB 6304, a bill that would have guaranteed continued funding in WA State for the CHIP program, which the federal government had threatened to de-fund. SB 6304 and its companion bill in the House, HB 2660, would not only have ensured that all children in Washington would have healthcare coverage; it also would have guaranteed prenatal care coverage for all childbearing people in the state, including those who are undocumented. The federal government has since reauthorized CHIP so neither of these bills are moving forward.
In addition to talking about these bills with members and their aides, we asked for support for an amendment to the budget proviso that passed last year, maintaining the cap on the midwifery licensing fee. Since 2009, when this fee cap went into effect, the licensed midwifery workforce in Washington has grown by 40%. Due to misinformation that we received last year from the Department of Health, the amount we’d requested from the legislature during the 2017 session was insufficient to cover the shortfall in the Midwifery Program budget at the DOH. For the most part, members were very receptive to our request that an additional $50,000 be allocated this year to fulfill on the intention of the proviso. To our surprise, Senator Fortunato (yes, that’s really his name) decided after meeting with several of his constituents, that we shouldn’t have to come back every year and ask for a budget proviso to keep our licensing fee reasonable. So, he introduced SB 6559 which would essentially put the midwifery fee cap into statute. Although the bill will not be going forward this session, it is encouraging that we have some support for a more permanent fix to our licensing fee issue. Rep. Monica Stonier, who introduced the budget proviso last year, has agreed to be our champion again and request the additional appropriation.
We also spent time in our meetings with legislators seeding the concept of title protection for birth centers, sharing the legislative language we have drafted to protect the terms “birth center,” “birthing center,” and “childbirth center” in statute, and conveying the thoughtful process we are engaging in with other stakeholders, including the WA State Hospital Association (WSHA) and the WA State Affiliate of the ACNM. The rationale for this effort is two-fold: 1) to protect consumers – we believe that families choosing a birth center for their care should be able to know what kind of care is actually offered in such a facility and what kinds of outcomes are achieved there; and 2) to preserve the integrity of the birth center model of care. The WSHA representatives we spoke with prior to session indicated that they understand our concerns, but they asked MAWS to wait until 2019 to introduce a bill so that they could have time to educate their members about the rationale for such legislation and give hospitals an opportunity to voluntarily re-brand as necessary. We agreed to do so—and heard from quite a few legislators how much they appreciated this collaborative approach.
Sen. Fortunato, however, was highly motivated to take action this year and decided to drop SB 6579. Although the bill will not get a hearing this session, Sen. Fortunato wanted to introduce the bill to convey to WSHA and their members that MAWS is serious about this effort and that we have legislative support. There is an increased sense of urgency about securing title protection for birth centers in Washington State since the introduction of a bill in Florida that would establish licensure for facilities called “Advanced Birth Centers.”
Please contact your Representatives and ask them:
Please contact your Senator and ask them:
As always, we would like to give a huge shout-out and thank you to MAWS lobbyist, Amber Ulvenes, for all her incredible work in support of midwives and families and to MAWS legislative liaison, Sasha Henry, who makes organizing our Lobby Day look easy.
Dear Members, Supporters, and friends of MAWS,
In an effort to eliminate racism throughout our organizations and do more than pay lip service to addressing the needs of communities of colors and the disparities perpetuated by systemic and personal racism, we are offering free memberships at all levels to people of color wishing to join (or renew membership in) MAWS in 2018. We are doing this in accordance with our Equity and Inclusion Values Statement and in solidarity with the Missouri Midwives Association Midwives of Color Chapter (MMA-MOC), which stated its hope to hold its state organization “accountable to the work of eliminating racially-based disparities, increasing racial diversity, and ensuring the promotion and perpetuation of anti-racist policies and procedures” that manifest in state organizations and throughout the midwifery community. We are inspired by the efforts of the MMA-MOC to actively recruit and retain candidates of color, and by their commitment to addressing “personal, organizational and structural racism inherent in all American social structures and at all strata of human interaction” that these efforts require. [see below the full statement of the MMA-MOC]
One of MAWS’ primary goals is to ensure that all families have access to safe, effective, and quality care. However, we recognize that systemic inequities as well as the personal privilege, biases, prejudices, and limited perspective of our predominantly white-led professional association are a hindrance to that goal. We acknowledge that we have a long way to go but will constantly strive to be more aware, more welcoming, and actively inclusive. And we cannot do it without creating more space in our organization for the participation and leadership of people of color. We humbly open our doors, our hearts, and our minds so that MAWS can become a truly representative professional midwifery association, able to deliver on its promise.
The Board of Directors of the Midwives' Association of Washington State
To claim your free membership, please email firstname.lastname@example.org. We want to hear from you!
Click here for our Equity and Inclusion Values Statement
MMA-MOC Statement in Support of Black Midwife Demetra Seriki
In the summer of 2012, the Missouri Midwives Association held their annual retreat in Kansas City, MO. At this meeting a discussion was introduced concerning the active recruitment of candidates from the Black community into the Missouri midwifery community. At that point there were no midwives of color and only one student of color in Missouri. Missouri Midwives Association was informed at this time, that an influx of Black candidates would mean that change would have to occur within MMA to accommodate women of color. The midwives present wanted to know what that change would consist of. That change meant dealing with the personal, organizational and structural racism inherent in all American social structures and at all strata of human interaction.
In the Fall of 2017, there were enough student midwives of color, according to MMA bylaw to form our own committee, the Midwives of Color Chapter. This committee has now formed, and we would like to issue as our first official statement, our solidarity with Colorado midwife, Demetra Seriki in her fight against continued marginalization and oppression. As an official chapter of the Missouri Midwives Association, we stand against racism, oppression and inequity in any of its insidious forms. We commit to one another, to our state organization, and to the African-American community at large that we will use our collective energies to fight those forces that have kept our communities locked in perpetual poor health outcomes, especially when it comes to maternal and infant health. Many give lip service to the concerns of our community, but we will show up to do the work of supporting, protecting, and promoting maternal and infant health in Missouri’s long neglected African-American communities.
We recognize that Missouri is not only not immune, but in some ways particularly at risk for replicating some of the issues seen in other states in the midwifery community. We hope to take preventative action by holding our state organization accountable to the work of eliminating racially-based disparities, increasing racial diversity, and ensuring the promotion and perpetuation of anti-racist policies and procedures manifested in our state organization and reflected throughout the midwifery model of care as practiced in the state of Missouri.
Missouri Midwives Association- Midwives of Color Chapter
Hakima Tafunzi Payne- Chapter President
Brittany Tru Kellman- Chapter Secretary
A message from the leadership of MAWS
The Midwives’ Association of Washington State joins the National Association of Certified Professional Midwives and the American College of Nurse-Midwives in publicly denouncing and condemning white supremacy, bigotry, and racial prejudice in all its forms.
We must all take this moment to examine ourselves, recognize our own places of privilege, and level the playing field wherever possible. What are our conscious and unconscious biases? How have most of us benefited from our white supremacist society, and how do we continue to uphold it? To our professional members, we urge you to evaluate your practice for openness and inclusivity. Do your practice handouts contain images of people of color? Do your informed consents use gender inclusive language? Birth Center members, do your facilities create a welcoming space for all people? Teachers and preceptors, are you raising the next generation of midwives to be more awake? Students, are you actively listening to your cohort of different backgrounds? Parents, how do you talk to your children about race? About gender?
Everything MAWS does is centered on the goal that ALL families, regardless of race, religion, income, sexual orientation, or gender identity, should have access to safe, effective, and quality care. We acknowledge that we have a long way to go, but we are constantly striving to be more aware, more welcoming, and actively inclusive. Please join us in declaring that bigotry, prejudice, and bias have no place in our hearts, our practices, and our communities.
To our friends, colleagues, students, and clients who are Black, Hispanic, Muslim, Jewish, undocumented, and transgender, we care about you. You are safe with us. Your lives matter. You are not a distraction. You are our family.
With love and solidarity,
The Midwives’ Association of Washington State
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Banner photo used with permission.